Pediatric Practice Trends amid COVID-19 Challenges

COVID-19 What s Happening in Community Practices?

What is happening in Pediatric Practices? Patient volumes are down. Phone call volumes vary but mostly are down. Practices are changing office flow, reducing operating hours, and staff hours. Telehealth visits are expanding. Practices are applying for loans. We re attending webinars. A lot of webinars.

Patient volumes are down

Changes in Office Flow: Are you Rooming patients from the car (zero waiting room time)? Allowing patients to self schedule (either in person or telehealth visits)? Alternating well and sick clinic times or days? Creating plans for conserving PPE? Creating plans for staff illness or quarantine?

Reduction of Office Hours/Services Most practices no longer have walk-in hours (for in-person visits) Some practices have initiated on demand visits (for telehealth visits) Decreased patient volumes = decreased hours of operation. NOTE: kids are still attending school, usually in the mornings Most practices still doing checkups age 2 and under Reproductive Health Services may actually be more in demand. Practices reducing staff hours, or enacting layoffs so staff can claim unemployment

Telemedicine Trends

Telemedicine: Childrens Practicing Pediatricians (CPP) experience Nearly all CPP practices have started telehealth/telemedicine in their practices. A variety of platforms being used (doxy.me, Zoom, and doximity being the most common HIPAA-compliant platforms). Some practices using non-HIPAA compliant resources such as FaceTime (which is allowable during the pandemic). Providers working from home Billing (reimbursement data still to come) New and established sick visits Well Visits not yet (stay tuned) Telemedicine: introduction of NEW WORKFLOWS

Telehealth Workflow Considerations How to schedule patients (consensus do this in blocks of time) What kind of visits (sick, follow up, med checks) to include Process for obtaining parent/patient consent How does patient get linked to the virtual waiting room and the visit? Develop a troubleshooting guide when the technology does not behave the way you anticipate Prepare patients for telehealth: https://kidzdoc.com/posts/doctornotes/telemedicine-virtual-visits- tips-for-a-great-visit-with-us-online/

Telehealth Coding Snippets Bill E/M code as you would for an in-person visit (9920x, 9921x) Managed Medicaid Plans, use GT modifier Other private plans CHECK WITH THE PLAN (most use 95 ) Use the 02 service location Effective April 1, new ICD-10 code to cover COVID-19 U07.1 (virus detected by testing) U07.2 (virus not detected by testing) Z20.828 Contact with and suspected exposure to other viruses Z03.818 Encounter for observation for suspected exposure to other biological agents, ruled out

Loans and Grants

Resources (some of which have WEBINARS) PFK: https://partnersforkids.org/news-updates/covid-19-resources-for- your-patients/ Nationwide Children s Hospital: https://www.nationwidechildrens.org/for- medical-professionals/refer-a-patient/covid19 Ohio AAP: http://ohioaap.org/covid19resources National AAP: https://services.aap.org/en/pages/2019-novel-coronavirus- covid-19-infections/ NCH Primary Care Connection: https://www.facebook.com/groups/613165485539765/ Bill Long: william.long@kidzdoc.com